18027 ANDOVER AVE.PDF1111111111 lill
10157
18027 ANDOVER
AVE
District
City of Edmonds — Water Department
TAP CARD
Reading: 00(0— .Date
No. No.
Meter Tap
{ Size /4 { Size
Mfgrs. No. :35 2r-5GII Style 62cKwc-L�- 42,
Purchaser: llclmu, R"wswl
Serv. Add. IS1011 �QUACWi-,,_ Z+XJ,-
Lot No. Blk. No.
Add.
Residential:
Other:,, -
Meter Location OP DR) Ue
top 67;_
S'ervice Material:
Pressure lbs. Test
Date of Work
Foreman
Guar. Vouceer NO. $
Proi. No: WTTS 0!�S'
Remarks: ftco A-PA-:10 rtElr/4 F-HOP 124C'
OUTGOING Index- Reg. -Route Bk. P Stcncil-Card-
INCOMING index— Reg. -Route Bk.- Stencil- Card-
I* ROUnNG SLIP "
, NEW SERVICE INSTALLATI
ADDRESS: �SCQl 0,4�16- ZALUt
DATE;
DIAL A DIG #
P.U.D.
cxp;;-F-1
TELEPHONY ' ' "-
CABLE T.V.
S
\J
GAS \�Du uuu-
FOREMAN
STORM SEWER
OTHER
FUTURE SERVICE INSTL: YES NO
BORE: CUT:
Ts a
LOCK
CREW
DATE: INITIAL:
UNLOCK
DATE: )�,/) 1;/ INITIAL:
METER SHOP
.3019 -
ACCOUNT NUMBER: -
SUPPLIER:AL,0 NAAr-
TREATMENT PLANT
FOREMAN
B
E T
FOREMAN
INITIAL: DATE:
TAP CARD
METER SHEET
APPLICAT ION
UTILITY
DISPATCH
I
BILLING
7/76
1:3
TAX ACCOUNT/PARCEL NUMBER: �-j VjLjt�obj b(�3D'3
BUILDING PERMIT (NEW STRUCTURE): 01's om
COVENANTS (RECORDED) FOR:
CRITICAL AREAS/ DETERMINATION: E] Conditional Waiver 0 Study Required 0 Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED: 11WO — 1�" z7p AV5
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): M7 6z-k,5 (5F
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:. I - I - V7
SEWER LID FEE $:
LID #:—I r. I
SHORT PLAT FILE: S 12 -Sq- LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED: 15 � Fj S1
LATEMP\DSTs\Fonns\Street File Checklist.doc
W
USE PERMIT
CITY OF EDMONDS ZONE,,? NUMBER F70283
CONSTRUCTION PERMIT APPLICATION 'O�
NAME fOR NAME OF BUSINE5S) ADDRESS 9017
I - N C.EC] SUBDIVISION NO.
i !,-L, : _� � LEGAL DESCRIPTIC!.
MALI[yG ADDRESS
1('3 r,� � ri
STAT
I ELIPHON1 NO MBER
22- (-Z6cl-L
C_ Nj V
��7;E N'U.�MB,111
"Ittit— Ileasements
I. a
OF_/3 5-/
NEW RESIDENTIAL
PLUMBING
AODfALTEP,
COMMERCIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN
El 0
FENCE
DEMOLISH
EXCAVATE
OR FILL
L_ Fr
0
P - OVE INSPJ
REMODEL
rpCIMPLIANCE INSP.
L_J Pool.
F�WOOD TO Ef
INSSERTV []
APT.BLDG
RENEWAL
NUMBER OF STORIES
NUMBER OF
DWELL G
0
UNITS
PUBLIC RlrHnwAY PEI OFFICIAL STREIT MAP,
EXI STING - - - FIGURED DEDICATION
OPOSED.(
PR 70
RIGHT OF WAY CONSTRUCTION PERMIT REOUIRE0
STREET USEPERMIT REOUIREO.:
SEE ENGINEERING �E.0 GATED �_,Z3
REMARKS
1,&� A/��
6��Lly�ewb
MERE
IBUILDING SUPPLY SIZE
IFIXTURE V�S
REMARKS
& Rg 6)
SIGN AREA
ALLOWED i P I ROPOSED
ENV' REVIEW
COMPLETE I EXEMPT
A 8 NO.
SHORELINE.
VARIANCE OR CU
PL.ANNING REVIEW BY
ff
YARDS
FPONT'2-15' SLOEI0' REA;2:�
LE,*��Td
LOT COVERAGE
FIE.AR��o
2- 9,�)S
CHECKED BY
-J-V,q
OF
C',
lqsl� :
HEIGHT
2T-1
SPECIAL INSPECTOR JAHEA
REOUIR D
r YES r_ NO
OCCUPANCY
GROUP
7 -?
OCCUPANT
LOAD
REMARKS
-71keemtAJ _7-,tq"(
PROGRESS INSPECTIONS PER UBC 305
VALUATION
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
I
GRAOINGIFILL
.
"' i 1.
This Permit cov work to be done on ONLY.
a 'a
private property
Any construction on the public domain (curbs, sidewelks..
driveways, marquees, etc.) will require saparate permission.
STATE SURCHARGE
1
1.4
Permit Application: 180 Days
ENERGY CODE
A -A 7
Permit Limit: 1 Year -Provided Work is Started Within 1800ays
Applicant, on behalf of his or her spouse. heirs, assigns an6
s.c in interest, agrees to indemnify. defend and hold
cesSors
harmless the City of Edmonds, Wash ngton., its officials.
mployces, a nd agents from any and all claims for damages of
whatever nature. arising directly or indirecuy from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
io C, CMKO) 453, -
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
S__g 7
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner. or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner - I agree to comply with city and
THIS PERMIT
This application is not a permit until
state laws regulat I ng construction; and in doing the work authoriz.
n
act thereby, o Person will be employed in violation of the Labor
AUTHORIZ
ONLY 4S
E
signed by the Building, Official or his
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy: and fees are paid, and receipt Is
jion Insuranco,
4� RE 'o' R OR A�EN� 1E SIGNED
INSPECTION
DEPARTMENT
acknowledged in space provided.
JDA
2
CITY OF
OFFICIAL'S SIGNAT RE DATE
EDMONDS
AT EN
AELR-ASED BY: A
r .
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTII../A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL - File YELLOW - Inspector
A CERTIFI CATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3,
PINK - Owner GOLD - Assessor
o2 78
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CITY ''of EDMO*
For I Inspection Call 771-3202 PUBLIC WORKS
1802,17
Sig SEWER
PERMIT NO
P I E R M . I
T
07694
EDMONDS
Address of Construction:
Property Legal Description (Include.al'l easemenis): Z-0 7 /3 S-1 2 -�?Ll
Owner and/or Builder:
Contractor & License No:
Singl:e Family Residence
Multi -Family (No. of Units
L..
'A S_
770 2- JFS
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No Yes
(If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
11271 excavation.) 9W-# B-7 11-r �?
& get
Cross other Private Property: No' -Yes: (If Yes, easement required,
attach legal -description and county easement number.)
PLEASE �EAD T I T S ED ON THE BACK
7
LI brti'�y N� and shaTT—comply Date
/ittlh the items listed on the back.
Permit Fee: 00 Issued By:
Trunk Charge: z -,s-- 00 Date Issued.- =6__�5_ Y 7-
Assessment Fee: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved: r7- 9-0.7
Date -Initial
Rejected:
Reason Date Initial
PERMIT MUST BE POSTED ON JOB SITE
Wh-ite Copy File Green Copy - Inspector Buff Copy Applicant
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The City of Edmonds
Side Sewer Drawing
EASEMENT NO - ------------------------------------ -------
NEW CONSTRUCTION H REPAIRS F� LID NO . .................. . AsmT. NO - ------------------
OWNER AOtA� ---- .................................... CONTRACTOR G?QL-alGGjF—k-S ---------------------------------------------- PERMIT No. 70A -----
JOB ADDRESS I.S.O.Z.1 ------ ----------------------- LEGAL DESCRIPTION: LOT NO. .]�> ----------- BLOCK NO. ---------- iOMONDS ... ..
_-RZATMENT PLAINIT
............................................................................................................................... � -1
NAME OF ADDITION ------------------------------------------------------------------
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PROP.
Approved:
WW-0011-1
1/75
8,.A.M7
DATEW�
By
(REVA 1/78)
...
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CITY OF EDMONDS
AONDS
N2 05271
NEW
ADDITION
RETIREMENT
STREET FILes*' INFORMATION SHEET
ASSET NO. /-7/
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
DEK. NO./
* *PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST.
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
INITIATED BY
DATE
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
a/DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATIONAMOUNT
G.L. ENTRY
REFERENCE
ttnp INITIAL
DATE
Aol�
VERIFIED BY
PROCESSED
BATCH NO
DEPARTMENT FILE